Noninvasive Blood Pressure Monitor Designed for Patients With Heart Failure Supported with Continuous-Flow Left Ventricular Assist Devices.
Noninvasive Blood Pressure Monitor Designed for Patients With Heart Failure Supported with Continuous-Flow Left Ventricular Assist Devices.
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DOI：
10.1097/mat.0000000000000775
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发表时间：
2019-03
期刊：
影响因子：
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通讯作者：
Johnson BD
中科院分区：
文献类型：
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作者：
Sajgalik P;Kremen V;Fabian V;Maltais S;Stulak JM;Kushwaha SS;Joyce LD;Schirger JA;Johnson BD
作为无创血压（BP）测量的金标准，多普勒技术不能提供收缩压（SBP）和舒张压（DBP），可能会限制治疗结果。为了改善患者护理，我们通过比较31名终末期心力衰竭患者（4名女性）在LVAD植入后2.6±3.4天（20名HeartMate II和11名HeartWare）的无创测量值与动脉内（I-A）BP，测试了专门设计的实验BP（ExpBP）监测仪和多普勒技术。Bland-Altman（B-A）图显示ExpBP监测器高估平均动脉压（MAP）1.2 [4.8] mm Hg（平均差[SD]），而多普勒高估6.7 [5.8] mm Hg。与相应的I-A压力相比，实验BP SBP高估0.8 [6.1] mm Hg，DBP高估1.9 [5.3] mm Hg。这两种技术实现了相似的测量可靠性。在测量“成功率”（表示为每次测量尝试的可读BP值的频率（百分比））中，多普勒实现了100%与ExpBP监护仪提供的MAP、SBP和DBP成功检测的97%、97%和94%。在大多数受试者中，除了提供SBP和DBP外，ExpBP监测仪在MAP评估方面的准确性高于多普勒。改善血压控制可能有助于降低相关神经系统不良事件发生率。
The gold standard for noninvasive blood pressure (BP) measurement, the Doppler technique does not provide systolic (SBP) and diastolic (DBP) pressure and may limit therapy outcomes. To improve patient care, we tested specifically designed Experimental BP (ExpBP) monitor and the Doppler technique by comparing non-invasive measures to the intra-arterial (I-A) BP in 31 end-stage heart failure patients (4 females) 2.6±3.4 days post-LVAD implantation (20 HeartMate II and 11 HeartWare). Bland-Altman (B-A) plots revealed that the ExpBP monitor overestimated mean arterial pressure (MAP) by 1.2 [4.8] mm Hg (mean difference [SD]), while the Doppler by 6.7 [5.8] mm Hg. The Exp BP SBP was overestimated by 0.8 [6.1] mm Hg and DBP by 1.9 [5.3] mm Hg compared to the respective I-A pressures. Both techniques achieved similar measurement reliability. In the measurement “success rate” expressed as a frequency (percent) of readable BP values per measurement attempts, Doppler accomplished 100% vs. 97%, 97% and 94% of successful detections of MAP, SBP and DBP provided by the ExpBP monitor. The ExpBP monitor demonstrated higher accuracy in the MAP assessment than the Doppler in addition to providing SBP and DBP in majority of subjects. Improved BP control may help to mitigate related neurologic adverse event rates.